Healthcare Provider Details

I. General information

NPI: 1932344694
Provider Name (Legal Business Name): HANOVER CHIROPRACTIC HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 ROCKLAND ST UNIT 1
HANOVER MA
02339-2226
US

IV. Provider business mailing address

24 ROCKLAND ST UNIT 1
HANOVER MA
02339-2226
US

V. Phone/Fax

Practice location:
  • Phone: 781-826-7397
  • Fax: 781-826-7469
Mailing address:
  • Phone: 781-826-7397
  • Fax: 781-826-7469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. THERESE JACOBS HENEY
Title or Position: BOOKKEEPER
Credential: D.C.
Phone: 781-331-8939